Mental health legislation

Question 1

What are the 2 main acts in mental health law in Scotland?

Answer 1

Mental Health (Care and Treatment)(Scotland) Act 2003
Adults with Incapacity (Scotland) Act 2000

Question 2

What are the criticisms of involuntary treatment?

Answer 2

Seen as ill-liberal
May be poorly compatible with Human Rights
Can be unnecessary
Can be counterproductive
Practical problems in administering treatments
?4 Ethical principles

Question 3

Why is there mental health law?

Answer 3

Power to provide compulsory care and treatment to people with mental disorder
Rights and safeguards to make sure those powers are used appropriately
Duty to provide with range of services for people with mental health disorder

Question 4

What are the principles of the Mental Health (Care and Treatment)(Scotland) Act 2003

Answer 4

Non-discrimination
Equality
Respect for diversity
Reciprocity
Informal care
Participation
Respect for carers
Least restrictive alternative
Benefit
Child welfare

Question 5

What is a mental disorder as defined by the Mental Health (Care and Treatment)(Scotland) Act 2003?

Answer 5

Any mental illness, personality disorder, learning disability however caused or manifested

Question 6

What does not count as a mental health disorder in the Mental Health (Care and Treatment)(Scotland) Act 2003?

Answer 6

Sexual orientation
Sexual deviancy
Transsexualism
Transvestism
Dependence on drugs/alcohol
Behaviour that is likely to cause harassment, alarm or distress to any other person
Acting as no prudent person would

Question 7

What does the Mental Health (Care and Treatment)(Scotland) Act 2003 give civil compulsory powers to do?

Answer 7

Detain
Assess
Treat

Question 8

Who determines the Mental Health (Care and Treatment)(Scotland) Act 2003?

Answer 8

An approved medical practitioner
Mental Health Officer (MHO)
Court

Question 9

Who can be detained?

Answer 9

> 18yrs

<18 if have child/adolescent specialist

Question 10

What are the civil compulsory powers?

Answer 10

Emergency detention certificate (EDC)
Short-term detention certificate (STDC)
Compulsory treatment order (CTO)
Nurses holding power

Question 11

How long can someone be detained under the EDC?

Answer 11

Up to 72hrs

Question 12

How long can someone be detained under the STDC?

Answer 12

Up to 28 days

Question 13

How long can someone be detained under the CTO?

Answer 13

Up to 6mo

Question 14

What are the details of an emergency detention certificate (EDC)?

Answer 14

Up to 72hrs
Authorises transfer to psychiatric hospital
Fully registered practitioner
MHO consent 'where practicable'
No right of appeal
Granting of STDC would be undesirable delay
Significant risk to self or others
Assessment & ER treatment only

Question 15

What are the details of a short-term detention certificate (STDC)?

Answer 15

28 days
Must be approved by an approved medical practitioner AND an MHO
Named person consulted
Assessment & treatment
Right of appeal

Question 16

What is the criteria for a STDC?

Answer 16

Person has mental disorder
Patient’s ability to make decisions about medical treatment sign. impaired as result of mental disorder
Necessary to detain patient in hospital for purpose of deterring treatment given
Significant risk to health, safety or welfare of patient or other people if patient not detained
Granting of certificate is necessary

Question 17

What is the MHTS?

Answer 17

Mental Health Tribunal Scotland

Question 18

What are the details for a compulsory treatment order (CTO)?

Answer 18

Up to 6mo
Application by MHO to MHTS
Two medical reports: GP/AMP
Proposed care plan
Criteria as for STDC
Community or hospital

Question 19

What are criteria for detention?

Answer 19

Mental disorder
Significant impairment of decision making ability for medical treatment about mental disorder
Significant risk to health, safety or welfare of person or to other people
Treatment available
Order necessary

Question 20

What is SIDMA?

Answer 20

‘Significant impairment of decision making ability’ about medical treatment for mental disorder

Question 21

When might someone have SIGMA?

Answer 21

Lack of insight
Cognitive impairment
Presence of psychosis
Severe depressive symptoms 
Learning disability

Question 22

What do the MHTS consider?

Answer 22

Civil applications and review civil/criminal orders
CTO applications
Appeals
2 yr mandatory review
Cross border transfers
Excessive security

Question 23

What are the police powers under the Mental Health (Care and Treatment)(Scotland) Act 2003?

Answer 23

Removal from public place
Appears to be in immediate need of care/treatment
Detain up to 24hrs
Purpose to allow assessment

Question 24

What is the Adults Without Capacity (Scotland) Act 2000?

Answer 24

Aged 16+
Incapable of:
acting, making decisions, communicating decisions, understanding decisions, retaining the memory of decisions
By reason of mental disorder or inability to communicate because of physical disability

Question 25

What are the principles when applying the Adults Without Capacity (Scotland) Act 2000?

Answer 25

Intervention must benefit the adult Intervention shall be least restrictive & consistent with purpose of intervention Account must be taken of past/present wishes of adult Account should be taken of views of relatives/carers, views of relevant others

Question 26

When is capacity presumed to be present?

Answer 26

Unless proven otherwise

Question 27

What four things in an assessment focus on of the criteria for capacity?

Answer 27

Communication Understanding Retention of info Decision

Question 28

What areas does the Adults Without Capacity (Scotland) Act 2000 influence?

Answer 28

Property Welfare (medical) Financial

Question 29

What are the orders that the Adults Without Capacity (Scotland) Act 2000 give?

Answer 29

Intervention order | Guardianship order

Question 30

What is the Intervention order?

Answer 30

One off power required | Application to court

Question 31

What is the guardianship order?

Answer 31

``` 2 doctors MHO application Needs to specify powers Can be financial/welfare/both Registered with office of the public guardian ```

Question 32

What can you not do under the Adults Without Capacity (Scotland) Act 2000?

Answer 32

Place an adult in hospital for treatment of mental order against his will

Question 33

Which one is statutory: advanced directive or advance statement?

Answer 33

Advance statement (MH(C&T)(S)A)

Question 34

What does the Adult Support and Protection (Scotland) Act 2007 protect?

Answer 34

Adults at risk: - unable to safeguard their own well-being, property, rights or other interests - at risk of harm and - because they are affected by disability, mental disorder, illness of physical or mental infirmity and are more vulnerable to harm

Question 35

What does harm include in the Adult Support and Protection (Scotland) Act 2007/?

Answer 35

Physical harm Psychological harm Conduct which causes self-harm Unlawful conduct e.g. theft, fraud, embezzlement, extortion